Breathe Well
Live Well
CommonHealth’s Guide to: Allergies Rhinitis & Sinusitis Asthma Chronic Obstructive Pulmonary Disease
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This guide is provided by the CommonHealth Wellness Program in the Department of Human Resource Management for state employees as part of the Breathe Well – Live Well educational campaign and is not intended as a substitute for professional medical advice.
If you or your family members have any of the symptoms of the health issues noted in this booklet, please consult with your health professional. For those with asthma or COPD who are also on the state’s health insurance plan (COVA Care or COVA HealthAware), you can choose to be part of an incentive program.
Anthem -Condition Care: Asthma and COPD For more information call 1-866-938-0349 or visit https://www.dhrm.virginia.gov/docs/defaultsource/benefitsdocuments/ohb/cova-conditioncare.pdf?sfvrsn=0
Aetna – Lifestyle and Condition Coaching For more information call: 1-866-533-1410 or visit https://www.dhrm.virginia.gov/docs/defaultsource/benefitsdocuments/ohb/aetna-wellness-programs-referencesheet.pdf?sfvrsn=0
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Breathe Well
Live Well
Asthma and allergies affect an estimated 15 million and 50 million people in the United States, respectively. Our own Richmond, Virginia, was named the asthma capital of the United States by the Asthma and Allergy Foundation of America1. Most of us know someone who suffers from asthma, allergies or another breathing challenge like Chronic Obstructive Pulmonary Disease (COPD). Perhaps that person is you. Breathing is something we all need to do in order to survive. CommonHealth wants you to be able to do more than simply survive, we want you to thrive! We’ve taken the time to compile some information on each of these three topics: allergies, asthma and COPD. This booklet provides easy to understand information, practical tips you can use immediately, and tools to help you achieve a high quality of life on a daily basis.
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http://www.webmd.com/asthma/ss/slideshow-10-worst-cities-for-asthma
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Is it a Cold or an Allergy?2
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Characteristic
Cold
Allergy
Duration
3-14 days
Days to months -- as long as you are exposed to the allergen
Time of Year
Most often in the winter, but possible at any time
Any time of the year -- although the appearance of some allergens are seasonal
Onset of symptoms
Symptoms take a few days to appear after infection with the virus
Symptoms can begin immediately after exposure to the allergen
Symptom
Cold
Allergy
Cough
Often
Sometimes
Aches
Sometimes
Never
Fatigue
Sometimes
Sometimes
Fever
Rarely
Never
Itchy, watery eyes
Rarely
Often
Sore throat
Often
Sometimes
Runny or stuffy nose
Often
Often
http://www.webmd.com/cold-and-flu/cold-guide/common-cold-or-allergy-symptoms 4
Although there are some differences, cold and allergy symptoms overlap quite a bit. The most important difference is that colds usually don't last longer than 14 days. If you still have symptoms after two weeks, see your doctor. These may be allergy symptoms or a sign of another problem.
Allergies Allergies are a common and chronic condition … one of the most common around the world. In the US, over 50 million people have allergies (one in five people3). Believe it or not, the Immune System is to blame for our allergic reactions. An allergen, to someone with allergies, is a foreign invader that must be stopped. The body’s immune system overreacts by producing Immunoglobulin E (IgE) antibodies. These antibodies travel to cells that release histamine and other chemicals, causing an allergic reaction. An allergic reaction typically triggers symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. For some people, allergies can also trigger symptoms of asthma. In the most serious cases, a life-threatening reaction called anaphylaxis (an-a-fi-LAK-sis) can occur. A number of different allergens are responsible for allergic reactions. The most common include:
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Pollen Dust Food Insect stings
Animal dander Mold Medications Latex
Source: www.Acaai.org
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Rhinitis and Sinusitis Seasonal allergic rhinitis (hay fever) is most often caused by pollen carried in the air during different times of the year in different parts of the country. Hay fever symptoms tend to flare up in the spring and fall. Allergic rhinitis can also be triggered by common indoor allergens such as the dried skin flakes, urine and saliva found on pet dander, mold, droppings from dust mites and cockroach particles. This is called perennial allergic rhinitis, as symptoms typically occur year-round. In addition to allergen triggers, symptoms may also occur from irritants such as smoke and strong odors, or to changes in the temperature and humidity of the air. This happens because allergic rhinitis causes inflammation in the nasal lining, which increases sensitivity to inhalants. Many people with allergic rhinitis are prone to allergic conjunctivitis (eye allergy). In addition, allergic rhinitis can make symptoms of asthma worse for people who suffer from both conditions. Allergic rhinitis symptoms include: • • • • • •
Itching in the nose, roof of the mouth, throat, eyes Sneezing Stuffy nose (congestion) Runny nose Tearing eyes Dark circles under the eyes
An allergist has specialized training and experience to diagnose specific allergens that trigger your illness, or to determine if your symptoms are non-allergic. Your allergist will take a thorough health history followed by allergy testing. Skin tests or blood tests are the most common methods for determining your allergic rhinitis triggers. Coping mechanisms include over-the-counter (OTC) medications, prescription medications, allergy shots and in some cases, using a neti pot4. If you have nasal congestion, facial pressure, cough and thick nasal discharge, you may have rhino-sinusitis, commonly referred to as sinusitis. Your sinuses are hollow cavities within your cheekbones, around your eyes and behind your nose. They contain mucus, which helps to warm, moisten and filter the air you breathe. When something blocks the mucus from draining normally, an infection can occur. Acute sinusitis refers to sinusitis symptoms lasting less than four weeks. Most cases begin as a common cold. Symptoms often go away within seven to 10 days; but in some people, a bacterial infection develops. 4
http://www.mayoclinic.org/diseases-conditions/common-cold/expert-answers/neti-pot/faq-20058305
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Chronic sinusitis, also referred to as chronic rhino-sinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment. People with allergic rhinitis or asthma are more likely to suffer from chronic sinusitis. This is because the airways are more likely to become inflamed when allergic rhinitis or asthma is present. Sinusitis may also be caused by an infection, a fungus, deviated nasal septum, and nasal polyps or in rare cases an immune system deficiency. Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include: • • • • •
Thick yellow-green nasal discharge Postnasal drip, often with a bad taste Cough Congestion Toothache
In cases of acute sinusitis, a fever may develop. Allergy testing performed by an allergist/immunologist can identify what allergic triggers might be behind your chronic or reoccurring sinus infections. Coping mechanisms include OTC medications, prescription medications, allergy shots and using a neti pot. In chronic or severe cases, your doctor may also examine your nasal passages using a technique called rhinoscopy5 or nasal endoscopy. In this procedure, a thin, flexible instrument is inserted up the nostril to view the sinus passages and look for blockages. Your doctor may order a MRI or CT scan to look for abnormalities in the sinuses – narrow drainage passages, polyps or a deviated septum. Make an appointment with your doctor right away if you have: a fever, pain or swelling in the face or eye, redness on the cheek or around the eye, severe headaches, confusion or a stiff neck.
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http://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/basics/tests-diagnosis/con-20022039
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How to Prevent or Diminish Allergy Symptoms
Kick Dust Mites Out of Bed Dust mites live in bedding, causing allergy and asthma triggers.
Use dust mite proof covers on mites pillows, Dust liv comforters, bedding, andcausing mattress. Washand allergy bedding asthma every week at triggers. o
130 & dry in
hot dryer.
Get Dust Mites Out of the Bedroom
Dust mites live in carpet.
Install hardwood floors or vinyl and washable Dust mites liv area rugs. bedding, Choose low-nap causing carpets as it allergy and holds less asthma allergens. triggers. Always vacuum with a HEPA filter.
Use Light and Breezy Window Treatments Heavy drapes and traditional blinds catch dust.
Use Washable cotton or synthetic curtains. Washable roller shades. Wipe window frames and glass to prevent mold and mildew.
De-clutter the Room
Use minimal fabric and less upholstery. Move books, magazines, and decorative items to another room. Dust your bedroom often. Don’t store items under the bed.
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How to Prevent or Diminish Allergy Symptoms
Protect Bedroom Air
Dust mites and mold like warm, damp bed clothes.
Use the air conditioning and a dehumidifier setlivat Dust mites 30-50%. bedding, Turncausing down the heat andand turn allergy up the AC. Dust asthma mites do not do triggers. o well under 77 F.
Make the bedroom a pet-free zone
The hardest of all – have your pet sleep elsewhere.
Pet fur with dander, saliva, and urine can Dustallergens. mites liv carry bedding, Do your best to causing wipe down allergy and your pet after asthma being outside triggers. and vacuum more often.
Ban Roaches
Roaches are creepy but a fact of life, especially in crowded cities or humid climates. Cockroach droppings bring on symptoms.
Seal cracks and crevices. Fix leaks in pipes and faucets – roaches thrive in water. Keep food tightly sealed. Consider hiring an exterminator.
Outdoors
Avoid being outside when allergens are high. After coming in, be sure to remove/wash clothing as soon as possible and take a shower and wash your hair. When working outside, consider wearing a mask to decrease exposure. Keep car windows up and use the recirculate button for air conditioning. 9
Asthma Asthma6 is a chronic (long term) lung disease that causes inflammation and narrows the airways making it difficult to breath. When the airways react, the muscles around them tighten and cells in the airway may make more mucus than normal, narrowing the airways even more. Symptoms include: • Wheezing - a whistling or squeaky sound that occurs when you breathe. • Tightness in your chest- this may feel like something is squeezing or sitting on your chest. • Shortness of breath – feels like you can't catch your breath or you feel out of breath. You may feel like you can't get air out of your lungs. • Coughing - coughing from asthma often is worse at night or early in the morning, making it hard to sleep. Sometimes symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, the symptoms may continue to get worse. When symptoms continue to get worse, more intense or additional symptoms appear, this is called an asthma attack. An asthma attack is very serious (can be fatal) and may require emergency care. For this reason, it’s most important to treat asthma symptoms when you first notice them to prevent them from getting worse and causing a life threatening asthma attack. You can’t prevent asthma, however, you can take steps to control it and prevent its symptoms. • • • • • •
Learn about your asthma and ways to control it. Follow your written asthma action plan. Use medicines as your doctor prescribes. Identify and try to avoid things that make your asthma worse (triggers). Keep track of your asthma symptoms and level of control. Get regular checkups for your asthma.
Asthma affects people of all ages and most often starts in childhood. We don’t know the exact cause of asthma but researchers believe it is a combination of genetics and exposure to certain environmental triggers. Most (but not all) people who have asthma also have allergies.
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http://www.webmd.com/asthma/ss/slideshow-asthma-overview
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Common Asthma Triggers If you have asthma, coming in contact with a trigger can cause a sudden worsening of symptoms and cause an asthma attack. Your health care provider can help you recognize what makes your asthma worse, and help find simple solutions to reduce and avoid triggers. If you have asthma, you should also have an asthma action plan. An asthma action plan is a written plan developed by your doctor or asthma specialist to help you or another family member, including teenagers and children, manage asthma and prevent asthma attacks. The plan is designed to tell you or other family members what to do when there are changes in the severity of asthma symptoms and in peak flow numbers. Partner with your doctor to develop an asthma action plan.7 This plan will help you know when and how to take your medicines. The plan also will help you identify your asthma triggers and manage your disease if asthma symptoms worsen. Pollen, weather & pollutions - Be prepared for the outdoors before leaving your home. Check pollen count, air quality, humidity, storms, etc. Pests & bugs in the home - store garbage outside, fix leaks, wash bedding regularly, vacuum & dust regularly, and use allergen-proof pillow and mattress covers. Chemical fumes & strong odors - use fragrance-free products when possible, and limit the use of strong perfumes, deoderants and personal care items. Fungus spores, dust and mold - clean visible dusty or moldy items, run a dehumidifier, and use the exhaust fan when showering. Smoke - cigarettes, wood burning fireplaces or burning leaves all make it hard to breathe. If you smoke, make a plan to quit. Limit exposure to tobacco smoke. Stress, emotions & anger - learn coping mechanisms to stressful situations, which can cause rapid breathing and increase trigger symptoms. Exercise - staying active is important to your health. Monitor air quality if you plan to exercise outdoors, and talk to your doctor about medication to help symptoms while you stay active.
Most people who have asthma can successfully manage their symptoms by following their asthma action plans and having regular checkups. However, knowing when to seek emergency medical care is important.
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http://www.webmd.com/asthma/guide/developing-an-asthma-action-plan
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Steps You Can Take NOW To Control Asthma USE MEDICATIONS CORRECTLY - If you take inhaled medicines, you should practice using your inhaler at your doctor's office. If you take long-term control medicines, take them daily as your doctor prescribes. TRACK YOUR SYMPTOMS - Record your asthma symptoms as a way to track how well your asthma is controlled. Also, your doctor may advise you to use a peak flow meter (a hand-held device that shows how well air moves out of your lungs). You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test. Your doctor may ask you to keep records of your symptoms and peak flow results daily for a couple of weeks before an office visit. These steps will help you keep track of how well you are controlling your asthma over time. This will help you spot problems early and prevent or relieve asthma attacks. Recording your symptoms and peak flow results to share with your doctor also will help him or her decide whether to adjust your treatment. HAVE REGULAR ASTHMA CHECKUPS – Your doctor will assess your level of asthma control and adjust your treatment as needed. Remember, the main goal of asthma treatment is to achieve the best control of your asthma using the least amount of medicine. This may require frequent adjustments to your treatments. FOLLOW YOUR ASTHMA ACTION PLAN - If you find it hard to follow your asthma action plan or the plan isn't working well, let your health care team know right away. They will work with you to adjust your plan to better suit your needs.
If you have any of these signs, see your doctor: • Your symptoms start to occur more often, are more severe, or bother you at night and cause you to lose sleep. • You're limiting your normal activities and missing school or work because of your asthma. • Your peak flow number is low compared to your personal best or varies a lot from day to day. • Your asthma medicines don't seem to work well anymore. • You have to use your quick-relief inhaler more often. If you're using quick-relief medicine more than 2 days a week, your asthma isn't well controlled. • You have to go to the emergency room because of an asthma attack. Your doctor might need to change your medicines or take other steps to control your asthma. Partner with your health care team and take an active role in your care. This can help you better control your asthma so it doesn't interfere with your activities and disrupt your life. 12
Call your doctor for advice if: • Your medicines don't relieve an asthma attack. • Your peak flow is less than half of your personal best peak flow number. Call 9–1–1 for emergency care if: • You have trouble walking and talking because you're out of breath. • You have blue lips or fingernails. Asthma has no cure. Even when you feel fine, you still have the disease and it can flare up at any time. However, with today's knowledge and treatments, most people who have asthma are able to manage the disease. If you have asthma, you can take an active role in managing the disease. For successful, thorough, and ongoing treatment, build strong partnerships with your doctor and other health care providers. Remember, you can control your asthma!
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Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that over time makes it hard to breathe. COPD includes chronic bronchitis and emphysema. With chronic bronchitis, the lining of the breathing tubes become swollen and produces a lot of mucus that gets coughed up. With emphysema, the walls of the air sacs in the lung are broken down and the air spaces get larger and air gets trapped. COPD is the third leading cause of death in the US. It causes serious long-term disability and early death. At this time there is no cure for COPD. More than 12 million people are known to have COPD and up to 24 million may have the disease due to some not even knowing it. The number of people dying from COPD is growing. Deaths due to COPD in women are higher than in men. COPD is often not found until the disease is very advanced. Sometimes people think they are short of breath or less able to do the things they are used to doing because they are "just getting old.” But shortness of breath is never normal. The good news is that COPD can be found early and there is much that can be done to treat and help manage the disease. What Causes COPD? COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs. Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke also may damage the lungs. It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60. You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare. Signs and symptoms of COPD include: Constant coughing, sometimes called "smoker's cough" Shortness of breath while doing everyday activities Producing a lot of sputum (also called phlegm or mucus) Feeling like you can't breathe or take a deep breath Wheezing Be sure to check with your health insurance provider about smoking cessation services. When you are ready to quit using tobacco, help is available. They will help you determine the plan that is best for you. For those with asthma or COPD who are also on the state’s health insurance plan (COVA are or COVA HealthAware), did you know that you can choose to be part of an incentive program? See Page 2 for details.
If you can quit smoking, you can slow the progression of COPD, and by doing so, you can lengthen your lifespan.
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Notes ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
More Resources Allergies http://www.aaaai.org/conditions-and-treatments/allergies.aspx Allergy symptoms http://www.webmd.com/allergies/tips-for-an-allergy-proof-bedroom Asthma http://www.lung.org/lung-disease/asthma/learning-more-about-asthma/ http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ Cold vs. Allergy http://www.webmd.com/cold-and-flu/cold-guide/common-cold-or-allergy-symptoms COPD http://www.lung.org/lung-disease/copd/ http://www.nhlbi.nih.gov/health/health-topics/topics/copd/ http://www.webmd.com/lung/copd/tc/chronic-obstructive-pulmonary-disease-copd-overview www.drive4COPD.org - take a simple self-assessment (developed by a group of national private and public organizations to help identify the more than 5 million people (estimated) in the U.S. with undiagnosed COPD). Rhinitis/Sinusitis http://www.aaaai.org/conditions-and-treatments/allergies/rhinitis.aspx Visit our website: www.commonhealth.virginia.gov Like us on facebook: www.facebook.com/commonhealthva
This quality health education program brought to you by CommonHealth, an Employee Program in the Department of Human Resource Management. CommonHealth began in 1986 and continues the mission to make Virginia’s employees the healthiest in the nation. 15
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